Dysarthria Archives - Page 3 of 5 - Marshalla Speech & Language

Tag: Dysarthria

Mobius Syndrome and Articulation Therapy

By Pam Marshalla

Q: What type of articulation therapy should be provided for children with Mobius Syndrome? I have only seen a few children with Mobius Syndrome, and those were seen for diagnosis only. As I understand it, facial paralysis is the main problem and the paralysis can involve some or all of the facial muscles, particularly the upper lip in most cases. The breadth and scope of the paralysis will guide speech involvement. One client I saw had paralysis only in the…

Misdiagnosing Mild Dysarthria as Apraxia

By Pam Marshalla

SLPs often overlook the diagnosis of mild dysarthria. This therapist’s letter perfectly describes such a client. My answer below summarizes the problems and offers links to treatment. Q: I was hoping you could provide some guidance for me with a student I am evaluating. She is 11 years old and has been in speech for R, L, S, Th for several years. I met her for the first time this week when I began her re-evaluation. The SLP who has…

Drilling on Correct Words

By Pam Marshalla

Q: In your presentation called Improving Intelligibility in Apraxia and Dysarthria you mentioned that it is important to practice phonemes that they can do, rather than phonemes they can’t do. Why is that? That’s a good question! Van Riper and other old-time SLPs said that about 75% of every therapy session should be a rehearsal of things the child can do correctly, and about 25% should be material that is new, unfamiliar, and challenging. Most SLPs today spend most…

Drilling Two-Year-Olds?

By Pam Marshalla

Q: My two-year-old son has dysarthria. We have been practicing his target words 100 times every day at home, but when he goes to speech sessions, his SLP only has him practice his words a few times. Can you comment on this? I don’t think she is working him hard enough. Drill has its place, but he is only 2 years old! You are giving him more practice than just about any toddler could handle. You do not want him…

Recommendations for Polymicrogyria

By Pam Marshalla

Q: My client is a five-year-old with polymicrogyria. He drools severely, eats only purees, basically is non-verbal, and has a non-verbal IQ of about 85. He is labeled as apraxic. Can you give me advice on how to proceed? I had not heard of this disorder, so I Googled it and found quite a bit under “polymicrogyria ” and “children with polymicrogyria.” Apparently it is a developmental malformation of the human brain characterized by an excessive number of small convolutions on the…

Hammer’s Cues for Apraxia

By Pam Marshalla

I recently attended a seminar on apraxia taught by David Hammer, SLP. It was fabulous and I highly recommend it to all my readers! David uses a combination of verbal cues, object cues, and gestural cues together in his work with apraxic children. He bases this speech training on the theory that children with apraxia need a multisensory approach that focuses on phoneme sequencing. The verbal cues he uses are names and phrases that describe the outstanding place, manner, and…

Pierre Robin Syndrome

By Pam Marshalla

Q: My two-year-old son has Pierre Robin Syndrome and cleft palate. He had oral surgery at 6-days of age, and again at 9 months. He makes a few sounds like “Eh-eh-eh,” “Mmmmm,” “Baba,” and “Papapa.” There has been little if any vocal play until just recently. Receptive skills are good and he signs many words. Can the syndrome be a cause for his delay? I need suggestions. Yes, the syndrome is most assuredly the cause of the delay. Surgeries and…

Apraxia and Dysarthria and Real Oral Motor Therapy

By Pam Marshalla

Q: Would you agree with the following statement: Children with apraxia will respond to structured production of increasingly difficult syllable shapes, while children with dysarthria need supplementing with oral motor exercises to address muscle weakness. Before I answer your question, let me say a few things about “muscle weakness” and dysarthria because many SLPs––including professors of articulation and phonology––do not seem to understand this area very well. The muscle weakness seen in dysarthria can have many different causes, and the…

Down Syndrome and Stuttering: Diagnostic Labels

By Pam Marshalla

Q: I have a student with Down syndrome who stutters. Her private SLP has diagnosed her as having apraxia, and insists that the fluency problem is part of the apraxia. Can this be right? Many therapists assign the label of apraxia to children with Down syndrome, but I believe that this is an incorrect diagnosis. Dysarthria should be the assigned disorder. Please note the following definitions: Dysarthria Dysarthria comprises a group of speech disorders resulting from disturbances in muscular control….

Eliminating Tooth Grinding

By Pam Marshalla

Q: I have two girls with Down syndrome who grind their teeth on a regular basis. They are the same age and function at about the same level. What strategies would you use to help with this area? This is a tough question. We have no widely accepted strategies to eliminate tooth grinding other than the dental guard recommended by dentists. But my thinking has always been that if you can pinpoint the cause, then you can design a solution…